If you are T1D for 50 years you are likely to test and inject yourself well over 50,000 times (assuming 3 a day, 365 and a quarter days, 50 years)! It is a tiring and frustrating process. Unlike your job, you cannot take a day off or a vacation. No matter where life takes you, T1D will always follow. Exhaustion and exasperation are inevitable.
I had a decade wher my pattern was probably:
- 1 month trying to resolve my diabetes health
- 5 months of burnout
- Repeat
Seeing numbers that seemingly made no sense and were completely random was so demoralizing to me, even though at these times I was motivated and was trying my hardest. However, the main reason why the results were unpredictable was because, without the knowledge, I was not able to evaluate and interpret them.
There is a massive difference between: knowledge of what you want to achieve and knowledge of how to achieve it. Yoyo management was the result of my lack of knowledge, guesswork dosing for meals and corrections.
EITHER
- Too much insulin
- Go severe hypo
- Overeat the hypo
- Go hyper
- Overcorrect the hyper
- Go hypo………
OR
- Insufficient insulin
- Go hyper
- Overcorrect the hyper
- Go hypo…….
- As above…..
Resolving burnout
The key to not suffering burnout, I beleive, is the knowledge and expectation. Know your body, know what to expect, know your rules, but dont always expect them to work. Understanmding how unpredictable T1d can be is a key to accepting it as such.
Have realistic and acheivable “big picture” control goals. Burnout is like falling off the bicycle. Dont expect that you can be a champion racer, be happy with a leisurely pedal and aim to speed up constantly, eventually, you’ll be a champion. And if you fall off, get back on and slow down a bit!
Meeting my personal goals feels great, I call it the success cycle, I enjoy riding it and i dont want to get off!
Another trick that works for me is to have high and aspirational “finer detail” compliance goals. If I could rate my compliance on a daily basis on:
- Procedural correctness – pen priming, fresh needles and post meal blood tests.
- Recording and calculating – writing details on app and doing an accurate calculation, writing in my book, observations post meal.
- Food timing and discipline – waiting a calculated time before eating and choosing not to eat food that makes control more difficult
If i gave it a score out of 10, it might be 9. (because no matter how aspirational i am, i will never change my lancet every time!)
I find that a burnout period reduces that by an amount. In my case, I might say 4. So in my burnout periods, I maybe comply at 5 out of 10.
- I drop the recording and calculating (although I would still do a mental calculation),
- procedural correctness (reusing needles and so on),
- Food discipline and timing (I might choose to eat my nemesis food, chips!!).
The net result is that my numbers although higher than desired, are relatively ok, and not catastrophic. This might last a few days or until I do have a bad event and I realise, I am much better at the 9 out of 10.
The contrast to that is that if I complied every day at 5 out of 10 and burnout caused me to drop by 4, I would drop to a 1 and virtually be doing nothing.